I’ve been a terrible blogger in these last few years,
and my ability to write has suffered...so you’re going to have to bear with me
here. I will wax a little abstract
and reflective here, as I try to find my voice again. It won’t be the same voice, because as a nurse and a human
being, I’ve had to change and evolve—some things are better, and some are a little worse (rusty, shall we say?). Initially, when
I first became a nurse, I wrote because the sheer amount of information coming
at me was overwhelming. In a
matter of just two years, I had changed my career completely, and it was
absolutely the right decision, but the gravity of each moment on the floor
weighed on me. To know something
abstractly, at the academic level, is one thing, but to synthesize that
knowledge and apply it to a dynamic situation, is quite another. And so, I let my neurotic self run
rampant, researching every fact and detail, arriving at work an hour early in
order to learn about the potential challenges of that day. You see, each decision, because of my
lack of experience back then, felt like I was about to either kill someone or
save someone—and to a large extent, I was right about that. For example, even the simple act
of giving lasix was a struggle. If
I gave it too fast, I was sure that I would cause ototoxicity (which I just
learned, while confirming how to spell ototoxicity, can be potentiated by Aminoglycoside—still
learning). So that one supposedly
simple task, along with the millions of other things that I had to do, felt like an eternity if I was to do them with any integrity at all. 12 hour
shifts felt like 48 hour days on another planet with a much slower
rotation. The long days on that planet, however, didn’t mean a slowing down on the planet's surface...far from it.
Part of me misses those days because of how
profoundly focused and curious I was.
I genuinely loved the job (still do), but the lions share of my dogged
mental effort was born mainly out of not wanting to cause harm. Not killing anyone is pretty much an
absolute necessity in this line of work, and a profound motivator. To compound matters, anyone who knows
me just a little bit, knows that I am a little ADD. When in a room, I’m pretty much absorbing everything that’s
being said, the overall temperature of the room, as well as psychological and
physical assessments of patients, nurses, doctors, nursing assistants, and even
the janitor. Taking in that much
information, simultaneously, is exhausting. So the 48 hour days felt like 96 hour days, because I was
always “on”.
Fast forward 6 years, and here I am. A somewhat “seasoned” nurse. So, out of necessity for not wanting to
kill myself, I had to adapt. I
couldn’t take all of those 96 hour feeling days. I was more than a little obsessed. Didn’t take breaks.
Didn’t take care of myself.
I essentially did all of the things that everyone tells you not to
do. All nurses, in their way, will
put others in front of their own needs.
It’s a part of our strength, and a large part of our weakness. It’s our “disease to please” as one RN
put it. I kind of love and hate
that phrase. It sits heavy in my
mouth, like a bad word. But like
all bad words, it has its purpose, and are often more effective at expressing
things than long-winded prose. But
I digress.
So where is my nursing now? Mostly better, and a little worse. I can’t quote you the exact pharmacological mechanism of
every med in encyclopedic fashion like I once did…but I know what’s normal and
can sniff out a spiraling patient versus a minor set back with the best of
them. I am comfortable with my
patients, whereas before, I was running around so incredibly frantically that I didn't know how to actually sit down and listen. At the beginning, I didn’t know how to
recognize the subtleties of a patient’s presentation. A mildly elevated temperature might go relatively unnoticed,
whereas now, because I can synthesize that temperature with coldish extremities,
mild leukocytosis, a normal blood pressure (but abnormally low for that
particular patient) and know that they are in the initial stages of going
septic.
I hate to say it, but a lot of is instinct now. I can sniff out the problem. Whether it be the new resident that is
more interested in appearing to care for his patients versus actually caring
for them (because they’re new inexperienced and scared shitless—as they should be) or knowing
that their is a problem with the overall skill set for a particular assignment. I know I need to get more specific with
these examples, and I will. I just
wanted to get to a jump off point.
A place where I’m a little more analytical and less instinctual. Writing has always inspired that process in me: the ability to listen to my own thoughts that are swirling by so fast that I often can't pay attention to any of them.
So, I’ve pretty much swung from one side of
the pendulum to the other. Whereas
before I had a lot of information and no experience, it almost feels like I’ve
forgotten much of the book knowledge and gotten a little too comfortable in my
ability to gauge a patient’s situation based on instinct. Maybe this is the time where I find
balance in my life—both personally and at work. Wouldn’t that be nice?
